Drug & supplement interaction

Stevia + Pioglitazone

Pioglitazone brand name: Actos.

Minor Interaction
The bottom line Minor

Stevia has a minor interaction with Pioglitazone. Theoretically, stevia might increase the risk for hypoglycemia when combined with antidiabetes drugs.

Read the full interaction report
SeverityMinor
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Stevia and Pioglitazone

Here is the interaction we found between these two, with the evidence behind it.

Minor

ANTIDIABETES DRUGS

Why this applies to Pioglitazone

Pioglitazone falls under ANTIDIABETES DRUGS — the group Stevia interacts with.

Theoretically, stevia might increase the risk for hypoglycemia when combined with antidiabetes drugs.
Preliminary clinical research in patients with type 2 diabetes suggests that taking a single dose of stevia extract 1000 mg reduces postprandial blood glucose levels when taken with a meal. However, other clinical research in patients with type 1 or type 2 diabetes suggests that taking stevioside 250 mg three times daily does not significantly affect blood glucose levels or glycated hemoglobin (HbA1C) after three months of treatment.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the honest picture with stevia and pioglitazone (Actos). The concern on file is mostly theoretical. Some small studies hint that concentrated stevia extract might nudge blood sugar a little lower, so in theory it could add to what pioglitazone is already doing and raise the chance of low blood sugar. Other research showed no real change in blood sugar or A1C over three months, so the evidence is genuinely mixed and weak.

In everyday terms, the pinch of stevia you stir into coffee or use as a sweetener is very unlikely to matter. If you decide to take concentrated stevia supplements, it's worth watching for signs like shakiness, sweating, or dizziness, and checking your sugars. Chat with your pharmacist or doctor before adding any stevia product for a health reason.

References
  1. Gregersen S, Jeppesen PB, Holst JJ, Hermansen K. Antihyperglycemic effects of stevioside in type 2 diabetic subjects. Metabolism 2004;53:73-6. PubMed
  2. Barriocanal LA, Palacios M, Benitez G, et al. Apparent lack of pharmacological effect of steviol glycosides used as sweeteners in humans. A pilot study of repeated exposures in some normotensive and hypotensive individuals and in Type 1 and Type 2 diabeti

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Stevia Also Interacts With Other Medications

Stevia has 1 moderate, 257 minor known drug interactions in our database — the Pioglitazone one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Stevia

Covers the 2,830 medications we’ve checked against Stevia. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Pioglitazone

This page covers Stevia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pioglitazone page lists 356 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 309 moderate · 41 minor.

From our pharmacist’s overview on the Pioglitazone page

“Most of what appears on this pioglitazone (Actos) list shares one trait: the ingredients lower blood sugar on their own, which sounds helpful until you remember pioglitazone already does that job for people with type 2 diabetes. Stacked together, they can push glucose too low, and I would read this list with genuine care.”

Reviewed by 2 · Jul 18, 2026

Open the Pioglitazone interaction page

One more smart check

Taking Stevia as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,899 real supplement products containing Stevia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Stevia. Your product may carry other ingredients that interact with Pioglitazone too, on top of Stevia — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Stevia and Pioglitazone Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Stevia
Top 10%

#132 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Pioglitazone
Steady interest

#2,253 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Stevia

What is Stevia?

  • Sugar substitute / sweetener
  • Blood sugar support in diabetes
  • Weight management
  • Blood pressure support
  • Reducing calorie intake

Stevia is a plant-based, calorie-free sweetener that is widely used as a sugar alternative and is considered safe in normal food amounts by major regulators. Purified stevia extracts have a good safety record, but evidence for medicinal benefits like lowering blood sugar or blood pressure is limited. Talk to your pharmacist or doctor before using stevia supplements for any health condition.

Read the full Stevia monograph & all interactions
Medication

About Pioglitazone

What Is Pioglitazone Used For?

Brand name: Actos

Pioglitazone tablets — sold as Actos and under the generic names Pioglitazone and Pioglitazone Hydrochloride — are used to improve blood sugar (glucose) control in adults with type 2 diabetes. They are taken along with diet and exercise, either alone or combined with other diabetes medicines such as a sulfonylurea, metformin, or insulin.

Pioglitazone is not for type 1 diabetes or diabetic ketoacidosis (a serious complication where the blood becomes too acidic). It only works when the body is still producing some of its own insulin.

See full Pioglitazone drug information
Keep checking

Other Drugs & Stevia

Browse every other medication we’ve checked against Stevia — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
1Moderate
257Minor
2,571No known interaction
Moderate

1 interaction

Minor

257 interactions

Showing 60 of 257 minor interactions — see all 257 on the Stevia page.

No interaction 2,571 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Pharmacist Counseling Corner

Taking Stevia and Pioglitazone Together: Common Questions

Can you take Stevia with Pioglitazone?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Stevia and Pioglitazone interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Pioglitazone and Stevia?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.